[Congressional Record (Bound Edition), Volume 154 (2008), Part 11]
[Senate]
[Pages 15514-15515]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           TEXT OF AMENDMENTS

  SA 5088. Mr. DURBIN (for Mr. Kennedy (for himself and Mr. Hatch)) 
proposed an amendment to the bill S. 901, to amend the Public Health 
Service Act to reauthorize the Community Health Centers program, the 
National Health Service Corps, and rural health care programs; as 
follows:

       In lieu of the matter proposed to be inserted, insert the 
     following:

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Health Care Safety Net Act 
     of 2008''.

     SEC. 2. COMMUNITY HEALTH CENTERS PROGRAM OF THE PUBLIC HEALTH 
                   SERVICE ACT.

       (a) Additional Authorizations of Appropriations for the 
     Health Centers Program of Public Health Service Act.--Section 
     330(r) of the Public Health Service Act (42 U.S.C. 254b(r)) 
     is amended by amending paragraph (1) to read as follows:
       ``(1) In general.--For the purpose of carrying out this 
     section, in addition to the amounts authorized to be 
     appropriated under subsection (d), there are authorized to be 
     appropriated--
       ``(A) $2,065,000,000 for fiscal year 2008;
       ``(B) $2,313,000,000 for fiscal year 2009;
       ``(C) $2,602,000,000 for fiscal year 2010;
       ``(D) $2,940,000,000 for fiscal year 2011; and
       ``(E) $3,337,000,000 for fiscal year 2012.''.
       (b) Studies Relating to Community Health Centers.--
       (1) Definitions.--For purposes of this subsection--
       (A) the term ``community health center'' means a health 
     center receiving assistance under section 330 of the Public 
     Health Service Act (42 U.S.C. 254b); and
       (B) the term ``medically underserved population'' has the 
     meaning given that term in such section 330.
       (2) School-based health center study.--
       (A) In general.--Not later than 2 years after the date of 
     enactment of this Act, the Comptroller General of the United 
     States shall issue a study of the economic costs and benefits 
     of school-based health centers and the impact on the health 
     of students of these centers.
       (B) Content.--In conducting the study under subparagraph 
     (A), the Comptroller General of the United States shall 
     analyze--
       (i) the impact that Federal funding could have on the 
     operation of school-based health centers;
       (ii) any cost savings to other Federal programs derived 
     from providing health services in school-based health 
     centers;
       (iii) the effect on the Federal Budget and the health of 
     students of providing Federal funds to school-based health 
     centers and clinics, including the result of providing 
     disease prevention and nutrition information;
       (iv) the impact of access to health care from school-based 
     health centers in rural or underserved areas; and
       (v) other sources of Federal funding for school-based 
     health centers.
       (3) Health care quality study.--
       (A) In general.--Not later than 1 year after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services (referred to in this Act as the ``Secretary''), 
     acting through the Administrator of the Health Resources and 
     Services Administration, and in collaboration with the Agency 
     for Healthcare Research and Quality, shall prepare and submit 
     to the Committee on Health, Education, Labor, and Pensions of 
     the Senate and the Committee on Energy and Commerce of the 
     House of Representatives a report that describes agency 
     efforts to expand and accelerate quality improvement 
     activities in community health centers.
       (B) Content.--The report under subparagraph (A) shall focus 
     on--
       (i) Federal efforts, as of the date of enactment of this 
     Act, regarding health care quality in community health 
     centers, including quality data collection, analysis, and 
     reporting requirements;
       (ii) identification of effective models for quality 
     improvement in community health centers, which may include 
     models that--

       (I) incorporate care coordination, disease management, and 
     other services demonstrated to improve care;
       (II) are designed to address multiple, co-occurring 
     diseases and conditions;
       (III) improve access to providers through non-traditional 
     means, such as the use of remote monitoring equipment;
       (IV) target various medically underserved populations, 
     including uninsured patient populations;
       (V) increase access to specialty care, including referrals 
     and diagnostic testing; and
       (VI) enhance the use of electronic health records to 
     improve quality;

       (iii) efforts to determine how effective quality 
     improvement models may be adapted for implementation by 
     community health centers that vary by size, budget, staffing, 
     services offered, populations served, and other 
     characteristics determined appropriate by the Secretary;
       (iv) types of technical assistance and resources provided 
     to community health centers that may facilitate the 
     implementation of quality improvement interventions;
       (v) proposed or adopted methodologies for community health 
     center evaluations of quality improvement interventions, 
     including any development of new measures that are tailored 
     to safety-net, community-based providers;
       (vi) successful strategies for sustaining quality 
     improvement interventions in the long-term; and
       (vii) partnerships with other Federal agencies and private 
     organizations or networks as appropriate, to enhance health 
     care quality in community health centers.
       (C) Dissemination.--The Administrator of the Health 
     Resources and Services Administration shall establish a 
     formal mechanism or mechanisms for the ongoing dissemination 
     of agency initiatives, best practices, and other information 
     that may assist health care quality improvement efforts in 
     community health centers.
       (4) GAO study on integrated health systems model for the 
     delivery of health care services to medically underserved 
     populations.--
       (A) Study.--The Comptroller General of the United States 
     shall conduct a study on integrated health system models at 
     not more than 10 sites for the delivery of health care 
     services to medically underserved populations. The study 
     shall include an examination of--
       (i) health care delivery models sponsored by public or 
     private non-profit entities that--

       (I) integrate primary, specialty, and acute care; and
       (II) serve medically underserved populations; and

       (ii) such models in rural and urban areas.
       (B) Report.--Not later than 1 year after the date of the 
     enactment of this Act, the Comptroller General of the United 
     States shall submit to Congress a report on the study 
     conducted under subparagraph (A). The report shall include--
       (i) an evaluation of the models, as described in 
     subparagraph (A), in--

       (I) expanding access to primary and preventive services for 
     medically underserved populations; and
       (II) improving care coordination and health outcomes; and

       (ii) an assessment of--

       (I) challenges encountered by such entities in providing 
     care to medically underserved populations; and
       (II) advantages and disadvantages of such models compared 
     to other models of care delivery for medically underserved 
     populations.

     SEC. 3. NATIONAL HEALTH SERVICE CORPS.

       (a) Funding.--
       (1) National health service corps program.--Section 338(a) 
     of the Public Health Service Act (42 U.S.C. 254k(a)) is 
     amended by striking ``2002 through 2006'' and inserting 
     ``2008 through 2012''.
       (2) Scholarship and loan repayment programs.--Section 
     338H(a) of the Public Health Service Act (42 U.S.C. 254q(a)) 
     is amended by striking ``appropriated $146,250,000'' and all 
     that follows through the period and inserting the following: 
     ``appropriated--
       ``(1) for fiscal year 2008, $131,500,000;
       ``(2) for fiscal year 2009, $143,335,000;
       ``(3) for fiscal year 2010, $156,235,150;
       ``(4) for fiscal year 2011, $170,296,310; and
       ``(5) for fiscal year 2012, $185,622,980.''.
       (b) Elimination of 6-Year Demonstration Requirement.--
     Section 332(a)(1) of the Public Health Service Act (42 U.S.C. 
     254e(a)(1)) is amended by striking ``Not earlier than 6 
     years'' and all that follows through ``purposes of this 
     section.''.
       (c) Assignment to Shortage Area.--Section 333(a)(1)(D)(ii) 
     of the Public Health Service Act (42 U.S.C. 
     254f(a)(1)(D)(ii)) is amended--
       (1) in subclause (IV), by striking ``and'';
       (2) in subclause (V), by striking the period at the end and 
     inserting ``; and''; and
       (3) by adding at the end the following:
       ``(VI) the entity demonstrates willingness to support or 
     facilitate mentorship, professional development, and training 
     opportunities for Corps members.''.
       (d) Professional Development and Training.--Subsection (d) 
     of section 336 of the Public Health Service Act (42 U.S.C. 
     254h-1) is amended to read as follows:
       ``(d) Professional Development and Training.--
       ``(1) In general.--The Secretary shall assist Corps members 
     in establishing and

[[Page 15515]]

     maintaining professional relationships and development 
     opportunities, including by--
       ``(A) establishing appropriate professional relationships 
     between the Corps member involved and the health professions 
     community of the geographic area with respect to which the 
     member is assigned;
       ``(B) establishing professional development, training, and 
     mentorship linkages between the Corps member involved and the 
     larger health professions community, including through 
     distance learning, direct mentorship, and development and 
     implementation of training modules designed to meet the 
     educational needs of offsite Corps members;
       ``(C) establishing professional networks among Corps 
     members; or
       ``(D) engaging in other professional development, 
     mentorship, and training activities for Corps members, at the 
     discretion of the Secretary.
       ``(2) Assistance in establishing professional 
     relationships.--In providing such assistance under paragraph 
     (1), the Secretary shall focus on establishing relationships 
     with hospitals, with academic medical centers and health 
     professions schools, with area health education centers under 
     section 751, with health education and training centers under 
     section 752, and with border health education and training 
     centers under such section 752. Such assistance shall include 
     assistance in obtaining faculty appointments at health 
     professions schools.
       ``(3) Supplement not supplant.--Such efforts under this 
     subsection shall supplement, not supplant, non-government 
     efforts by professional health provider societies to 
     establish and maintain professional relationships and 
     development opportunities.''.

     SEC. 4. REAUTHORIZATION OF RURAL HEALTH CARE PROGRAMS.

       Section 330A(j) of the Public Health Service Act (42 U.S.C. 
     254c(j)) is amended by striking ``$40,000,000'' and all that 
     follows and inserting ``$45,000,000 for each of fiscal years 
     2008 through 2012.''.

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